Professional Responsibility Workload Report Form SAMPLE ...

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Dated: Copies: (1) Manager (2) ONA Rep (3) Chief Nursing Officer (or designate) (4) ONA Member (5) LRO - 4 -
- 5 - ONA/HOSPITAL PROFESSIONAL RESPONSIBILITY - WORKLOAD REPORT FORM GUIDELINES AND TIPS ON ITS USE The parties have agreed that patient care is enhanced if concerns relating to professional practice, patient acuity, fluctuating workloads and fluctuating staffing are resolved in a timely and effective manner. The collective agreement provides a problem solving process for nurses to address concerns relative to patient care. This report form provides a tool for documentation to facilitate discussion and to promote a problem-solving approach. PRIOR TO SUBMITTING THE WORKLOAD REPORT FORM PLEASE FOLLOW THE PROBLEM SOLVING PROCESS BELOW AND AS OUTLINED IN THE COLLECTIVE AGREEMENT ARTICLE 8. PROBLEM SOLVING PROCESS 1) At the time the workload issue occurs, discuss the matter within the Unit/Area/Program to develop strategies to meet patient care needs using current resources. Using established lines of communication, seek immediate assistance from an individual identified by the Employer (e.g. team leader/charge nurse/coordinator/supervisor) who has responsibility for timely resolution of workload issues. 2) Failing resolution of the workload issue at the time of the occurrence, discuss the issue with the Manager (or designate) on the next day that both the employee and Manager (or designate) are working or within five (5) calendar days, whichever is sooner, and complete the form. 3) When meeting with the manager, you may request the assistance of a Union representative to support/assist you in the meeting. Every effort will be made to resolve the workload issues at the unit level. A Union representative shall be involved in any resolution discussions at the unit level. All discussions and action will be documented. 4) Failing resolution, submit the Professional Responsibility Workload Report Form to the Hospital-Association Committee within twenty (20) calendar days from the date of the Manager’s response or when she or he ought to have responded under Article 8.01 (a)(iii). (SEE BLANK REPORT FORM ATTACHED TO THESE GUIDELINES.) 5) As per Article 8, the Hospital-Association Committee shall hear and attempt to resolve the complaint to the satisfaction of both parties. Any settlement/resolution under 8.01 (a)(iii) (iv) or (v) of the collective agreement will be signed by the parties. 6) If the issue remains unresolved it shall be forwarded to an Independent Assessment Committee as outlined in Article 8 of the Collective Agreement within the requisite number of days of the meeting in 4) above. 7) The Union and the Employer may mutually agree to extend the time limits for referral of the complaint at any stage of the complaint procedure. TIPS FOR COMPLETING THE FORM 1) Review the form before completing it so you have an idea of what kind of information is required. 2) Print legibly and firmly as you are making multiple copies. 3) Use complete words as much as possible. Avoid abbreviations. 4) As much as possible, you should report only facts about which you have first-hand knowledge. If you use second-hand or hearsay information, identify the source if permission is granted. 5) Identify the CNO standards/practice/guidelines/hospital policies and procedures you believe to be at risk. College of Nurses Standards can be found at www.cno.org. 6) Do not, under any circumstances, identify patients/residents.
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Professional Responsibility Workload Report Form SAMPLE ...

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